Uncomplicated Diverticulitis Masquerading as Symptomatic Ovarian Cyst in a Young Female

Document Type

Conference Proceeding

Publication Date

10-1-2024

Publication Title

Am J Gastroenterol

Abstract

Introduction: Diverticulitis is an overwhelmingly common diagnosis in the field of gastroenterology. However, it is currently a diagnosis of high suspicion only in elderly to middle aged patients. Signs and symptoms of diverticulitis overlap with many alternative diagnoses. The differential is particularly broad in young female patients. Here we present a case of diverticulitis in a young female patient that was previously masquerading as symptomatic ovarian cyst. Case Description/Methods: A 19-year-old woman with prior history of symptomatic ovarian cyst requiring resection months prior presented with 4-day history of right lower quadrant pain associated with nausea and diarrhea. She denied fevers or chills. She reported symptoms consistent with recurrence of prior episodes of symptomatic ovarian cyst. Exam was pertinent for right lower quadrant tenderness. Vitals signs remarkable for initial tachycardia with lab work showed leukocytosis to 13.0, unremarkable liver profile, lipase, urinalysis and pregnancy testing. Computed tomography Abdomen Pelvis with contrast was performed and showed findings of wall thickening and pericolonic fast stranding with multiple colonic diverticula at the level of mid ascending colon to the hepatic flexure concerning for diverticulitis. She was started on amoxicillin-clavulanate and noted to have significant improvement. She was discharged with a 5-day course of antibiotics to follow-up outpatient for colonoscopy. Discussion: Acute diverticulitis is 1 of the leading gastrointestinal-related causes of hospitalization with diagnostic delay resulting in increased risk of associated complications including abscess formation, fistulation, and sepsis. Recent trends have demonstrated a rising incidence of diverticulitis in younger patients resulting in a disconnect between clinical suspicion and disease prevalence. Moreover, studies have indicated diverticulitis in younger patients can present with increased severity and likelihood of recurrence. Differential diagnoses of recurrent abdominal pain should remain broad even with prior diagnoses of gynecologic etiology. Guidelines for treatment are not standardized therefore early intervention and appropriate follow-up should be arranged to ensure adequate long-term care of affected patients (see Figure 1).

Volume

119

Issue

10

First Page

S1973

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